Examining Mental Health Practitioners' Comfort with Sex and Sexuality

Background and Purpose:

Sex and sexuality are prevalent constructs in movies, advertising, and social media, yet active and healthy conversations about sex and sexual well-being are often missing from social work research, education, and practice. Perhaps reflecting the societal taboo around sexuality, social work educators often avoid discussing sexuality in their classrooms, and as a result, practitioners also routinely avoid sexuality in practice. This study examined mental health practitioners' training, knowledge, and comfort addressing issues related to sexuality.

Methods:

This exploratory descriptive study gathered data from a convenience sample via an anonymous digital survey. Eligibility requirements included a mental health degree and/or license and to have practiced in the U.S. during the last six months.

Of the 259 participants, 56.6% were social workers, 16.7% were PhDs and 8.7% were clinical psychologists. Participants had been practicing a mean of 15 years (SD = 12.4), and saw an average of 19 (SD = 8.8) clients per week. The majority identified as cisgender female (67.2%), White (86%), and non-Hispanic (86%). Responses represented practitioners from 32 of the 50 U.S. States.

Results:

Almost half of the participants (47.4%) had received 0 to 4 hours of content related to sexuality during their graduate education, three-quarters (74%) had received less than 15 hours, and less than half (39%) had taken a graduate course in sexuality. Three-quarters of participants (78.5%) had taken a workshop or training related to sexuality. Half (48.3%) always or often brought up sex with their supervisees, but 21% rarely or never raised the issue in their own supervision. Half (49.4%) reported their graduate programs left them feeling unprepared or very unprepared to work with clients related to sex.

Participants rated their knowledge and comfort with 24 issues related to sexuality on a scale from 1 to 5. Summed scores created a knowledge score and a comfort score (range 24 - 120). Interestingly, practitioners scored higher on comfort (X = 109.3, SD = 11.1) than on knowledge (X = 82.9, SD = 21.1). Mean scores on individual items indicated practitioners felt most knowledgable about safer sex, sexual identity, contraception, and sexual assault. Participants reported the least knowledge about people engaged in sex trade, people who perpetrated sexual violence, and sexuality and disability issues. Practitioners reported the greatest comfort working with sexual identity, safer sex, contraception, and puberty. They expressed the least comfort working with people who had perpetrated sexual assault, people engaged in sex trade (soliciting and providing), and BDSM/kink related issues.

Conclusion and Implications:

The results indicate a lack of education and training around issues of sexuality for mental health practitioners in the U.S. Integration of sexuality related content throughout graduate training is essential to ensure much needed workforce development.